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August 1966

Dysthyroid Exophthalmos: Palliation by Lateral Orbital Decompression

Author Affiliations

Miami, Fla; Boston
From the Howe Laboratory of Ophthalmology, Harvard University Medical School, Massachusetts Eye and Ear Infirmary, Boston. Dr. Kroll is now at the Bascom Palmer Eye Institute, Miami, Fla.

Arch Ophthalmol. 1966;76(2):205-210. doi:10.1001/archopht.1966.03850010207010

Dysthyroid1 (endocrine) exophthalmos remains a difficult problem in clinical management. The different forms of therapy advocated by different authors suggest that none is yet entirely satisfactory.2 The purpose of this report is to evaluate the efficacy of the lateral orbital decompression operation (Krönlein) for patients with severe disease in whom local and medical measures seem to be inadequate to preserve vision.

Materials and Methods  A total of 32 lateral orbital decompression operations were performed upon 18 patients with severe dysthyroid exophthalmos (Table). Of the 18 patients, 16 were the private patients of one of us (V.G.C.). The indications for surgery were (1) progressive exposure keratopathy, (2) progressive decrease in visual acuity, or (3) severe discomfort, despite local and medical measures.The patients' ages ranged from 34 to 73 at time of operation with an average of 51. There were eight men and ten women. Fourteen, had bilateral and

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